BMC Health Services Research
Volume 7, 2007

Impact on and use of an inner-city London Infectious Diseases Department by international migrants: A questionnaire survey (Article) (Open Access)

Cooke G. , Hargreaves S. , Natkunarajah J. , Sandhu G. , Dhasmana D. , Eliahoo J. , Holmes A. , Friedland J.S.*
  • a Department of Infectious Diseases and Immunity, Imperial College, Hammersmith Hospital Campus, London, W12 ONN, United Kingdom
  • b Department of Infectious Diseases and Immunity, Imperial College, Hammersmith Hospital Campus, London, W12 ONN, United Kingdom
  • c Department of Infectious Diseases and Immunity, Imperial College, Hammersmith Hospital Campus, London, W12 ONN, United Kingdom
  • d Department of Infectious Diseases and Immunity, Imperial College, Hammersmith Hospital Campus, London, W12 ONN, United Kingdom
  • e Department of Infectious Diseases and Immunity, Imperial College, Hammersmith Hospital Campus, London, W12 ONN, United Kingdom
  • f Statistical Advisory Service, Imperial College, London, SW7 2AZ, United Kingdom
  • g Department of Infectious Diseases and Immunity, Imperial College, Hammersmith Hospital Campus, London, W12 ONN, United Kingdom
  • h Department of Infectious Diseases and Immunity, Imperial College, Hammersmith Hospital Campus, London, W12 ONN, United Kingdom

Abstract

Background. The UK has witnessed a considerable increase in immigration in the past decade. Migrant may face barriers to accessing appropriate health care on arrival and the current focus on screening certain migrants for tuberculosis on arrival is considered inadequate. We assessed the implications for an inner-city London Infectious Diseases Department in a high migrant area. Methods. We administered an anonymous 20-point questionnaire survey to all admitted patients during a 6 week period. Questions related to sociodemographic characteristics and clinical presentation. Analysis was by migration status (UK born vs overseas born). Results. 111 of 133 patients completed the survey (response rate 83.4%). 58 (52.2%) were born in the UK; 53 (47.7%) of the cohort were overseas born. Overseas-born were over-represented in comparison to Census data for this survey site (47.7% vs 33.6%; proportional difference 0.142 [95% CI 0.049-0.235]; p = 0.002): overseas born reported 33 different countries of birth, most (73.6%) of whom arrived in the UK pre-1975 and self-reported their nationality as British. A smaller number (26.4%) were new migrants to the UK (≤10 years), mostly refugees/asylum seekers. Overseas-born patients presented with a broad range and more severe spectrum of infections, differing from the UK-born population, resulting in two deaths in this group only. Presentation with a primary infection was associated with refugee/asylum status (n = 8; OR 6.35 [95% CI 1.28-31.50]; p = 0.023), being a new migrant (12; 10.62 [2.24-50.23]; p = 0.003), and being overseas born (31; 3.69 [1.67-8.18]; p = 0.001). Not having registered with a primary-care physician was associated with being overseas born, being a refugee/asylum seeker, being a new migrant, not having English as a first language, and being in the UK for ≤5 years. No significant differences were found between groups in terms of duration of illness prior to presentation or duration of hospitalisation (mean 11.74 days [SD 12.69]). Conclusion. Migrants presented with a range of more severe infections, which suggests they face barriers to accessing appropriate health care and screening both on arrival and once settled through primary care services. A more organised and holistic approach to migrant health care is required. © 2007 Cooke et al; licensee BioMed Central Ltd.

Author Keywords

[No Keywords available]

Index Keywords

hospitalization refugee primary medical care public health service population demography London human Communicable Diseases Refugees middle aged statistics Self Report controlled study pathology Aged primary infection ethnology Urban Health Hospitals, Teaching statistical significance health Hospitals, Municipal Humans classification Severity of Illness Index chi square distribution male Chi-Square Distribution female Aged, 80 and over hospital department questionnaire public hospital teaching hospital Article health care Public Health Administration Questionnaires communicable disease adult migration major clinical study United Kingdom Utilization Review Emigration and Immigration Hospital Departments health hazard Health Services Accessibility primary health care health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-34547688957&doi=10.1186%2f1472-6963-7-113&partnerID=40&md5=59070ef71c03c6e01b9833af378e5ad9
DOI: 10.1186/1472-6963-7-113
ISSN: 14726963
Cited by: 11
Original Language: English